Parkinson’s, when he needs nursing home vs AL.

Penguina,

I am so sorry. I thought he was already in ALF. I’m glad you have hospice.
I read your bio but somehow off I went with him in ALf. Well since he is not, then no, he probably would not be accepted at this stage. Although when DH aunt went into ALF she was on hospice and bedfast. She had an aide that went with her from home, she had her hospice care and the ALF was good for her to be there. She went in with them knowing it was temporary. She transferred to the SNF to get rehab and then on private pay a few months and then transitioned to Medicaid. DH aunt had dementia and was about 94 at the time. They did offer for her to stay as she had been there long enough for them to see that her care was light compared to the active ones.

I had an aunt with Parkinson’s and LBD. My cousin cared for her at home along with my uncle who developed vascular dementia. It was very hard. My cousin paid a terrific price in her own mental health and QOL. My aunt passed at home. She was very sweet and easy to care for. Not so much my uncle.

We have a small number of posts (relatively speaking) who mention divorce. Usually it is implied that once a person has dementia, no divorce but I have never had a need to speak with an attorney on this subject. I did see a poster just last night who said she was having to divorce her DH of 15 years due to needing to file for Medicaid.

I googled SC divorce and this came up which might be something to look over before your meeting with your attorney. Please know that all attorneys do not have the same level of experience.


https://www.south-carolina-divorce.com/Medicaid-Divorce.html

Penguina,
Read this article about Lewy Body
https://parkinsonsblog.stanford.edu/category/webinars/
My husband has Parkinson’s but no dementia.
If his mobility declines and he requires wheelchair that will be 2 people’s transfer. He will need 24/7 care.
If he declines slowly as he is healthy otherwise unless something else comes along, then person with PD can live 20+ years.
I looked at my own situation and I can see our only option going to AL as caregiving expenses would exceed our budget.
It is the best as we stay together and the worst for me as I am some 20 years younger than most in AL, healthy and extremely independent.
Either way, I think us as spouses are going to face tough choices.

Has your DH been evaluated for hospice care? Many ALF will allow continued residence if on hospice. The reason is not that he could die w/n 6 months from his health condition but that they would get the extra care from the hospice company. Plus they don’t have to send him to an ER for every bump or issue. They or you call the hospice company who help make the decision of next steps. A broken bone, he would probably go, though not always, pneumonia, maybe not these just as an example. When he passes the hospice will coordinate with the funeral home and he doesn’t have to be sent to the hospital or medical examiner first (in many states). This may be a state specific call. Your ALF, hospice or the attorney can advise.

Please do go to the certified elder attorney. It is very important not to do these things that are so important for the rest of both your lives w/o the best advice you can find. But prior to that have a talk with his doctor and the management at the ALF about any options and his prognosis.

If you decide to talk to hospice Negotiate for a daily CNA but know that it might only be two or three times a week. A nurse will come at least weekly and will be on call. The time to get concessions is before you sign the papers. And always know you can change your mind.

It all depends on the flexibility of the ALF he is in if they will keep him on. The ALF will likely have a hospice provider they use or you may have friends who have used one they liked and would recommend. Talk to more than one. They are not all the same. And if he does have to transfer to a SNF at some point, know that the same hospice company can see him wherever he is if you make that a requirement ahead of time. That gives you continuity of contact regardless of the changes that might take place in the ALF or NH. My DH aunt has had the same hospice from home, to ALF and now at SNF.

Separation of assets is the attorney will determine which portion of your assets and income should go to each of you. A home is exempt at this point and one car is allowed. Sometimes when a spouse goes on Medicaid the community spouse (you) may need a portion of the Medicaid spouse’s income in order to manage their own life. There are established formulas/amounts allowed. The attorney can help you with that as it is state specific and individual circumstances are considered.
The ALF would be easier for you but of course they don’t usually take Medicaid so it would continue to be private pay.

Its time for DH to be in LTC. He has too much wrong with him for an AL or MC.

An Elder lawyer can split assets you may have. DHs going towards his care when almost gone you apply for Medicaid. Once on Medicaid, you remain in the home, have a car and enough of your monthly income to live on.

Try another Elder Law Attorney if yours is cancelled, because this is something you need expert advice on, not the opinions of a mess of folks on the internet. You can't afford to be wrong about separation of finances.

And yes, now is the time your hubby would need MC or nursing home for care.

You have exploring to do asap. No attorney who reschedules you over and over is worth seeing AT ALL. Find another in your area. You should be able to get this question answered from Trust and Estate attorney as well.